The goal of this retrospective study is to compare the effects of hydrotherapy and land-based exercise on pelvic floor muscle endurance in pregnant women. The main question it aims to answer is whether pelvic floor muscle endurance differs between women who participated in hydrotherapy and those who participated in land-based exercise. Researchers will compare existing clinical records of pregnant women who received hydrotherapy or land-based exercise. The study will examine pelvic floor muscle endurance measured using the Modified Oxford Grading (MOG) and other available pelvic floor assessments. The study will use information already recorded during routine care. No new exercise program or treatment will be given as part of this retrospective study.
Pelvic floor muscles support the bladder, bowel, and reproductive organs and play an important role in maintaining pelvic floor function during pregnancy. Pregnancy can place increased demands on these muscles because of changes in body weight, posture, hormonal changes, and pressure on the pelvic floor. Exercise during pregnancy may help maintain pelvic floor muscle function. Hydrotherapy provides exercise in water, where buoyancy can reduce the load on the body and may allow pregnant women to exercise with greater comfort. Land-based exercise is another commonly used approach for maintaining physical function during pregnancy. However, it is not clear whether hydrotherapy and land-based exercise are associated with different levels of pelvic floor muscle endurance. This retrospective study will review existing clinical records of pregnant women who participated in hydrotherapy or land-based exercise. The researchers will compare the available pelvic floor muscle assessment findings between the two groups to determine whether pelvic floor muscle endurance differs between the exercise approaches. The findings may provide information about the potential role of hydrotherapy and land-based exercise in maintaining pelvic floor muscle function during pregnancy. The results may also help physiotherapists make informed decisions when selecting exercise approaches for pregnant women.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
256
A structured hydrotherapy-based pelvic floor muscle training program conducted in a heated indoor therapy pool. Sessions were performed for 30 minutes, three times per week for six weeks, under the supervision of a trained physiotherapist. The water temperature was maintained at 32°C-34°C. Each session included warm-up and diaphragmatic breathing, pelvic floor muscle activation in supported buoyant positions, dynamic aquatic strengthening, and cool-down. Pelvic floor contractions were performed using the "squeeze and lift" technique, with three sets of 10 contractions held for five seconds. Aquatic exercises included water walking, hip movements, side leg raises, and supported squats using flotation devices or light aquatic equipment. Sessions concluded with stretching, relaxation, and breathing exercises.
A structured land-based pelvic floor muscle training program conducted in a clinical exercise setting. Sessions were performed for 30 minutes, three times per week for six weeks, under the supervision of a trained physiotherapist. Each session included warm-up and diaphragmatic breathing, pelvic floor muscle activation, dynamic land-based strengthening, and cool-down. Pelvic floor contractions were performed using the "squeeze and lift" technique, with three sets of 10 contractions held for five seconds. Land-based exercises included walking, supported squats, hip movements, side leg raises, and functional strengthening exercises with controlled breathing and postural alignment. Sessions concluded with stretching, relaxation, and breathing exercises.
Saveetha Medical College and Hospital (SMCH)
Chennai, Tamil Nadu, India
Change in Pelvic Floor Muscle Endurance measured using Perineometer
Pelvic floor muscle endurance will be assessed using a perineometer, which measures the intravaginal pressure generated during voluntary pelvic floor muscle contractions. Participants will be instructed to perform sustained pelvic floor muscle contractions, and the pressure generated will be recorded in centimeters of water (cmH₂O). The perineometer provides an objective measure of pelvic floor muscle function and endurance. Measurements will be recorded at each assessment time point and analyzed as changes within and between the hydrotherapy-based pelvic floor muscle training and land-based pelvic floor muscle training groups.
Time frame: Baseline (Week 0), Week 3, Week 6
Change in Pelvic Floor Muscle Strength measured using Modified Oxford Grading Scale
Pelvic floor muscle strength will be assessed using the Modified Oxford Grading Scale through digital vaginal palpation. Muscle strength will be graded from 0 to 5, with 0 indicating no palpable contraction and 5 indicating a strong contraction against resistance. The MOGS score will be recorded at each assessment time point and analyzed to determine changes in pelvic floor muscle strength within and between the hydrotherapy-based pelvic floor muscle training and land-based pelvic floor muscle training groups.
Time frame: Baseline (Week 0), Week 3, Week 6
Change in Urinary Incontinence Severity measured using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form
Urinary incontinence severity will be assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. The questionnaire assesses the frequency and severity of urinary leakage and its impact on everyday life. The total score will be recorded at each assessment time point, with higher scores indicating greater severity and impact of urinary incontinence. Changes in scores will be analyzed within and between the hydrotherapy-based pelvic floor muscle training and land-based pelvic floor muscle training groups.
Time frame: Baseline (Week 0), Week 3, Week 6
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